GP Insights

We intend to upload articles and videos created by our doctors which provides some local insight into topical health issues and news.

Hypertension (high blood pressure)

Listen to Drs Baxter & Widnall talk about why it's important to know what your blood pressure is, what it could mean if it's high.

Reducing cholesterol with statins and other medication

Why have I been offered a statin, and what should my cholesterol be?

The National Institute of Health and Care Excellence (NICE) recommends that for the primary prevention of cardiovascular disease the target is to reduce person's non-HDL cholesterol by at least 40%.

What does that actually mean?

Primary prevention is the aim of reducing the risk of a cardiovascular event (for example, a heart attack or a stroke) in people who have never previously had one. (Secondary prevention is reducing the risk of a further event in somebody who has already had an event.)

Non-HDL cholesterol ("bad cholesterol") is considered a "bad cholesterol" because it can cause the build-up of fatty material in your arteries. In absolute numbers, less than 4.0mmol/L is considered a healthy level, but after a heart attack or stroke, below 2.6mmol/L is a healthy level. However, recognising that lots of things can affect a person's cholesterol level, rather than just aim for less than 4.0 for everyone, the recommendation is that treatment should achieve a 40% reduction from your starting level.

Calculating your target is easy. Have a look on your NHS App at your investigation results find the figure for your non-HDL cholesterol. Put that number into your phone's calculator, and multiply by 0.6. Next time we check your cholesterol after starting a statin we want the new level to be less than that number.

Example

  • Before treatment non-HDL cholesterol is 5.6 mmol/L
  • 5.8 * 0.6 = 3.36
  • Target non-HDL cholesterol is less than 3.36 mmol/L

What if it isn't below that target?

If  the desired reduction has not been achieved with the starting dose of medication and all of your lifestyle changes (these are still really important!) then we can gradually increase the dose of medication to improve things further.

You can read more about this topic on the British Heart Foundation website.